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Asymptomatic Bacteriuria and Urinary Tract Infection in Pregnant Women with and without Diabetes Mellitus and Gestational Diabetes Mellitus—A Case-Control Study

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Journal of Diabetes Mellitus 2017年第3期7卷 184-194页

作者： caroline schneeberger Suzanne E. Geerlings Jan Jaap H.M. Erwich Edwin R. Van Den Heuvel Philippa Middleton caroline A. Crowther Department of Medical Microbiology Academic Medical Center (AMC) University of Amsterdam Amsterdam The Netherlands Australian Research Centre for Health of Women and Babies Robinson Institute (ARCH) University of Adelaide Adelaide Australia Department of Internal Medicine division of Infectious Diseases Academic Medical Center (AMC) University of Amsterdam Amsterdam The Netherlands Department of Obstetrics and Gynaecology University Medical Center Groningen (UMCG) University of Groningen Groningen The Netherlands Department of Mathematics and Computer Science Technical University Eindhoven Eindhoven The Netherlands The Liggins Institute University of Auckland Auckland New Zealand

Background: Asymptomatic bacteriuria (ASB) and urinary tract infections (UTI) during pregnancy may contribute to adverse pregnancy outcomes. Diabetes mellitus (DM) and gestational diabetes mellitus (GDM) are considered to be important additional risk factor for ASB and UTI during pregnancy. Aims: To investigate differences in prevalence of ASB and incidence of UTI in pregnant women with and without DM and GDM to inform ASB screening and treatment policies. Methods: Data from 214 pregnant women who gave birth during 2010 at the Women’s and Children’s Hospital, Adelaide, Australia where cases were women with a clinical diagnosis of (G)DM and controls were matched on date of birth. ASB was defined as the growth of at least 10e5 colony forming units/ml of one organism or any presence of group B streptococcus (GBS) at the first urine culture collected during pregnancy without complaints of a UTI. A clinical UTI was diagnosed by the treating physician, in combination with a positive urine culture it was defined as culture-confirmed UTI. Results: No significant differences in prevalence of ASB (5.6% and 3.7%;relative risk (RR) 1.50;95% confidence intervals (CI) 0.44 - 5.17), incidence of clinical UTI (4.7% and 11.2%;RR 0.42;95% CI 0.15 - 1.14) or culture-confirmed UTI (2.8% and 3.7%;RR 0.75;95% CI 0.17 - 3.27) between pregnant women with and without (G)DM were present. No association was found between ASB and UTI. GBS was the most common causative organism of ASB in women with and without DM (66.7% and 50.0%). Conclusion: In contrast with earlier research, no significant differences in prevalence of ASB or incidence of UTI was found between pregnant women with and without (G)DM.

关键词： Urinary Tract Infections Bacteriuria Diabetes Mellitus Pregnancy Antenatal Screening

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Recurrence of urinary tract infections in postmenopausal diabetic women using different antibiotics

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Journal of Diabetes Mellitus 2012年第2期2卷 261-263页

作者： caroline schneeberger Ronald P. Stolk J. Hans DeVries Ron M. C. Herings Suzanne E. Geerlings Department of Epidemiology University Medical Center Groningen University of Groningen Groningen The Netherlands Department of Internal Medicine Academic Medical Center (AMC) Amsterdam The Netherlands Department of Internal Medicine Division of Infectious Diseases Center for Infection and Immunity Amsterdam Academic Medical Center (AMC) Amsterdam The Netherlands Utrecht PHARMO Institute Utrecht The Netherlands

Objectives: Postmenopausal women with diabetes mellitus (DM) have an increased incidence of urinary tract infections (UTI) compared to women without DM. The aim of this study is to compare recurrence rates of UTI in postmenopausal women with DM after treatment with nitrofurantoin, the agent of first choice following the Dutch guidelines, with two other common prescribed antibiotics trimethoprim and norfloxacin. Methods: We used a PHARMO database with pharmacy dispensing data. A total of 8534 postmenopausal (>55 years) women with DM who received a first course of nitrofurantoin, trimethoprim or norfloxacin were included. The UTI recurrence rates after treatment with these three different antimicrobial agents were compared. Recurrence was defined as a second prescription for nitrofurantoin, trimethoprim or norfloxacin or a first with fosfomycin, amoxicillin, fluoroquinolones, or trimethoprim/sulfamethoxazole between 6 and 30 days after inclusion. Results: Postmenopausal women with DM had significantly more UTI recurrences when they were treated with nitrofurantoin (22.7%) compared to trimethoprim (17.7%) or norfloxacin (14.2%) irrespective of the treatment duration. There was a trend that longer treatment duration was associated with higher recurrence rates. Conclusions: Postmenopausal women with DM had more UTI recurrences when they are treated with nitrofurantoin, agent of first choice, compared to trimethoprim or norfloxacin.

关键词： Antibiotics Urinary Tract Infections Infectious Diseases Treatment Diabetes Mellitus

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